Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Dec;6(4):481-493.
doi: 10.1007/s13300-015-0131-1. Epub 2015 Sep 19.

A 5-Year Follow-up Study to Assess Clinical Outcomes of Patients with Diabetes Undergoing Lower Limb Angiography for Significant Peripheral Artery Disease

Yisu Gu  1 , Chatchai Kokar  2 , Catherine Gooday  3 , Darren Morrow  3   4 , Ketan Dhatariya  5
Affiliations

A 5-Year Follow-up Study to Assess Clinical Outcomes of Patients with Diabetes Undergoing Lower Limb Angiography for Significant Peripheral Artery Disease

Yisu Gu et al. Diabetes Ther. 2015 Dec.

Abstract

Introduction: The optimal management for patients with diabetes and peripheral vascular disease-intermittent claudication or critical limb ischemia (CLI)-remains undetermined.

Methods: In a single-center retrospective analysis, we compared 1- and 5-year amputation-free survival rates in patients undergoing angiography subsequently treated with medical therapy or revascularization.

Results: 78 patients were included, 56 with CLI (mean age 77 years); 22 with claudication (mean age 75 years). Of the CLI cohort, 30 patients were medically treated. Their 1-year amputation-free survival rate was similar to those treated with revascularization (46.7% versus 50.0%, respectively). 8 patients in the claudicant cohort were treated conservatively. The 1-year amputation-free survival rate was 75.0% for conservative treatment versus 78.6% in those revascularized. Within the CLI cohort, in those conservatively treated 20% underwent major, and 16.7% minor amputations, compared to 15.4% and 23.1% in those revascularized. At 5 years in the claudicant cohort, the amputation-free survival rate was 37.5% with medical treatment, versus 71.4% for those treated with revascularization. For CLI, the 5-year amputation-free survival rate was 10% for conservative treatment, versus 26.9% for revascularization.

Conclusion: We found similar rates of amputation at 1 year for patients treated medically or revascularized. However, at 5 years, the amputation-free survival rate was markedly higher in revascularized patients compared to those medically managed. Our study highlights the potential role of predicting life expectancy when considering treatment, with the option of surgical treatment offered to those in whom survival is predicted to be longer than 5 years. However, larger studies with matched cohorts are now needed to confirm these findings.

Keywords: Amputation; Angiography; Diabetes; Peripheral vascular disease.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
a, b One-year clinical outcome of patients treated by medical versus revascularization for presentations of critical limb ischemia and claudication
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. International Diabetes Federation. IDF diabetes estimates. 2014. http://www.idf.org/atlasmap/atlasmap. Accessed Aug 28, 2015.
    1. Boulton AJ. The diabetic foot: grand overview, epidemiology and pathogenesis. Diabetes Metab Res Rev. 2008;24:S3–S6. doi: 10.1002/dmrr.833. - DOI - PubMed
    1. Fowkes FG, Rudan D, Rudan I, et al. Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. Lancet. 2013;382:1329–1340. doi: 10.1016/S0140-6736(13)61249-0. - DOI - PubMed
    1. Johannesson A, Larsson G-U, Ramstrand N, Turkiewicz A, Wirehn A-B, Atroshi I. Incidence of lower-limb amputation in the diabetic and nondiabetic general population. A 10-year population-based cohort study of initial unilateral and contralateral amputations and reamputations. Diabetes Care. 2009;32:275–280. doi: 10.2337/dc08-1639. - DOI - PMC - PubMed
    1. Kerr M. Foot care for people with diabetes: The economic case for change. 2012. https://www.diabetes.org.uk/Documents/nhs-diabetes/footcare/footcare-for.... Accessed Jul 20, 2015.

LinkOut - more resources